Caregiving can be stressful, and older adults’ health and well-being may be impacted by the roles and responsibilities they assume as caregivers for persons with serious mental illness (SMI). This study is the first to apply the Stress Process Model of Caregiving (SPM) in an attempt to understand how mental illness stigma influences caregiver outcomes, specifically their desire to relinquish care. The intent of this study was to call attention to care relinquishment as an under-studied stress process outcome and to explore stress factors, with a focus on mental illness stigma, that contribute to SMI caregivers’ desire to relinquish care. Using convenience sampling, members of the National Alliance on Mental Illness in the eastern U.S. were invited to participate in an online survey, resulting in a sample of n = 285. Regression analysis findings suggest that caregivers’ partnership status, exposure to problematic behaviors, and perceptions of courtesy stigma predicted desire to relinquish care. Neither age nor caregiver sense of mastery moderated the relationship between perceived courtesy stigma and relinquishment desire. Perceptions of stigma were negatively associated with caregiver health, sense of mastery, and social support levels, indicating stigma’s role in the erosion of caregiver resources. This study provides information that can inform the development of educational and supportive services that may help caregivers better cope with the stressors associated with SMI caregiving. With caregiving stressors diminished, older caregivers will be able to better apply their resources toward self-care and maintaining their quality of life.

Bakgrund: Psykisk ohälsa betraktas idag som ett folkhälsoproblem. Patienter med psykisk ohälsa lider ofta av samsjuklighet och vårdas därför ofta inom somatisk vård. Vårdvetenskapen förespråkar ett helhetsperspektiv på människan där kropp och själ samverkar och den ena delen aldrig kan uteslutas. Vid psykisk ohälsa kan lyhördhet i vårdrelationen vara avgörande. Sjukvårdspersonal upplever dock att de saknar kunskap i att vårda patienter med psykisk ohälsa. Syfte: Syftet var att belysa patienters upplevelser av att vårdas inom somatisk sjukvård i samband med psykisk ohälsa. Metod: Litteraturöversikt genomfördes med tio vetenskapliga artiklar, åtta med kvalitativ design och två med kvantitativ design. Artiklarna analyserades enligt Fribergs (2012) metod för litteraturöversikt. Resultat: Sex huvudteman identifierades: upplevelser av att möta sjukvårdspersonal, att känna sig förstådd, att vårdgivaren följer upp, att få vara delaktig, hinder för vård och trygghet. Diskussion: Utifrån Erikssons teori om vårdrelation och lidandet diskuteras resultatet. Kunskapsbrist kring psykisk ohälsa skapar osäkerhet hos sjukvårdspersonalen och lidande för patienten. Betydelsen av att se hela människan diskuteras. / Background: Mental illness is nowadays considered a public health problem. Patients with mental illness often suffer co-morbidity and are therefore often cared for within somatic care. According to caring science the holistic perspective of the human with both body and soul is advocated where one part can never be excluded. Sensitivity in the caring relationship can be crucial for a patient suffering from mental illness. However, health personnel themselves experience a lack of knowledge caring for patients with mental illness. Aim: The aim of the literature review was to illustrate patients´ experiences of being cared for within somatic care in conjunction with mental illness. Method: Literature review including ten scientific articles was implemented, eight with a qualitative design and two with a quantitative design. The articles were analyzed according to Friberg’s (2012) method for literature review. Results: Six main themes were identified: experiences of meeting health personnel, experiences of being understood, follow-up by the caregiver, experiences of being involved, experiences of barriers for care and security. Discussion: The result is discussed according to Eriksson's theory of the caring relationship and suffering. Lack of knowledge within mental illness creates insecurity among health personnel and also creates suffering for the patient. The importance of seeing to the human as a whole is discussed.

Bakgrund: Psykisk ohälsa är en växande folkhälsosjukdom globalt och nationellt. Suicid och suicidförsök är en allvarlig konsekvens av den psykiska ohälsan. Människor med psykisk ohälsa blir stigmatiserade av samhället såväl inom hälso- och sjukvård, vilket leder till att människor undviker att söka vård. Sjuksköterskor kommer att möta patienter med psykisk ohälsa i alla verksamheter. Stigmatisering utgör ett hinder för god och jämlik vård. Utbildning leder till mindre fördomsfulla attityder. Sjuksköterskeutbildningen i Sverige är ett treårigt högskoleprogram som leder till yrkes- och kandidatexamen inom ämnet omvårdad. Syfte: Syftet med studien var att kartlägga omfattningen av psykiatri och psykiatrisk omvårdnad inom svenska sjuksköterskeprogram på grundnivå. Metod: En tvärsnittsstudie med kvantitativ ansats. Resultat: Resultat från 24 av 25 sjuksköterskeprogram i Sverige. Omfattningen beträffande kurser inom psykiatrisk omvårdnad varierar mellan lärosätena. Det är upp till varje enskilt lärosäte att bestämma omfattningen, både gällande högskolepoäng och verksamhetsförlagd utbildning. Procentandelen för kurser inom psykiatrisk omvårdnad i relation till utbildningens 180 högskolepoäng ligger mellan 3,1 till 11 procent. Slutsats: Omfattningen av utbildning inom psykiatri och psykiatrisk omvårdnad ser olika ut på respektive lärosäte. Klinisk betydelse: Den ojämna omfattningen kan påverka omvårdnaden för patienter i den kliniska verksamheten. / Background: Mental illness is a growing public health disease globally and nationally. Suicide and suicide attempts are a serious consequence of mental illness. People with mental illness are stigmatized by society and within health care, resulting in people avoiding to seek care. Nurses have a key role in interacting with patients and will encounter patients with mental illness in all settings. Stigma is an obstacle of equitable health care. Education leads to less prejudiced attitudes. Nursing education in Sweden is a three-year undergraduate program leading to a vocational and bachelor’s degree in Nursing. Aim: The aim of the study was to identify the extent of Psychiatric Nursing courses in Swedish nursing programs at the undergraduate level. Method: A cross-sectional study with a quantitative approach. Results: Results from 24 of the 25 nursing programs in Sweden regarding the scope of courses in psychiatric nursing. The extent varies between institutions, both in theoretical and clinical training, and it is up to each institution to decide the scope. The percentage of courses in psychiatric nursing in relation to the 180 credits is between 3.1 to 11 percent. Conclusion: The extent of Psychiatric Nursing courses varies in each institution. Clinical implications: The variation of these courses can affect the care of patients in the clinical practice.

Bakgrund: Psykisk ohälsa är något som berör många och är den vanligaste orsaken till sjukskrivning i Sverige. Förutom patientens förändrade tillvaro kan även närstående påverkas negativt såväl som positivt. Närstående till patienter med psykisk ohälsa kan uppleva en utmanande tillvaro med olika former av påfrestningar och det är vanligt att närstående själva får rollen som informella vårdare.                                                                                                                                                            Syfte: Att utifrån närståendes erfarenheter undersöka olika sätt att hantera livet tillsammans med någon med psykisk ohälsa. Metod: En litteraturöversikt gjordes. Sökning av artiklar utfördes i tre olika databaser. Studien baseras på tolv artiklar med kvalitativ, kvantitativ samt mixad-metod design. Roys adaptionsmodell valdes som teoretisk utgångspunkt. Resultat: Resultatet beskriver hur närstående hanterar och bearbetar deras tillvaro vilket beskrivs utifrån det övergripande huvudtemat anpassning med sina fem tillhörande underteman, acceptans, förändring och ökad kunskap, kontroll och balans, distansering samt ett sökande efter stöd. Ett sökande efter stöd och acceptans var mest framträdande vad gäller hur närstående hanterade deras tillvaro. Detta kunde innebära att acceptera hur den aktuella situationen såg ut eller att söka stöd hos familj och vänner. Diskussion: Resultatet diskuteras utifrån Roys adaptionsmodell och de fyra funktionsområdena fysiologiska behov, självuppfattning, rollfunktion samt relation och samhörighet. / Background: Mental illness is something that affects many people and it is the most common reason for sick leave in Sweden. Except for changed life circumstances regarding the patient, it may also have negative or positive effects on relatives. Relatives to patients suffering from mental illness may experience challenging life circumstances and various kinds of burdens. It is also common for relatives to receive a role as an informal caregiver. Aim: Based on relative's experiences, the aim of this study was to explore how relatives manage life together with someone with mental illness. Method: A literature overview was conducted. In the search for articles three different databases were used. The work is based on twelve articles with qualitative, quantitative and mixed-method design. Roy's Adaptation Model was used as a theoretical framework. Results: The results describe how relatives manage and process their life, which is being described from the overall theme adaption along with the sub-themes acceptance, change and enhanced knowledge, control and balance, alienation and a search for support. A search for support and acceptance was most prominent regarding to how relatives managed their life. An example of this could be that relatives accepted the current situation as it was or searched for support within the family or from friends. Discussion: The results are being discussed on the basis of Roy's Adaptation Model and its four adaptive modes; physiologic-physical, self-concept, role function and interdependence.

Background: Obsessive-compulsive disorder (OCD) affects 2 % of the population and leads to restrictions in many occupations, in many life domains and environments. In half of the cases the existing treatment is not enough and leads to emotional and physical exhaustion. The underlying causes behind the diagnosis is not fully clarified but methods in occupational therapy has the potential for evaluation and development in symptom management. Purpose: To identify and describe the experiences in persons with OCD regarding supporting and hindering factors in occupational performance. Method: A literature review with data from three personal blogs and one self-biography was analyzed using a qualitative content analysis leading to five categories. Result: The five categories are: Occupations are restricted or can’t be performed as preferred; Strategies are used to control occupational performance but could trigger compulsions; Meaningful occupation bridges difficult tasks and promotes occupation. The degree of anticipation controls if external stimuli inspires activity or triggers compulsions; Social support increases the ability to carry out activity. The result depicts both hindering and supporting factors affecting occupational performance. Still factors are too complex to divide because supporting strategies also are self-destructive or only work in some situations. Conclusion: Persons with OCD have supporting, hindering and paradoxical strategies and there were factors to facilitate occupational performance in preferred and necessary activities. The social support was the most prominent supporting factor for quality of life and occupational performance.

Då det är känt att den psykiska ohälsan ökar är det betydelsefullt att undersöka hur elever med psykisk ohälsa upplever sin hälsa i skolan och hur de anser att skolsköterskor kunde eller borde agera. Bipolär sjukdom är en kronisk cyklisk stämningslägessjukdom, med depression, hypomani och mani, vilken kan bero på både ärftliga faktorer såväl som faktorer i miljön. Det är viktigt att det finns en hög medvetenhet om dessa tillstånd bland dem som möter barn med problem. Skolsköterskor är centrala för elevhälsans arbete och som barnens representanter är de skyldiga att våga se, lyssna och fråga dem om psykisk ohälsa.   Syftet med studien var att beskriva hur personer med bipolär sjukdom upplevde sin psykiska hälsa under skoltiden. Studien genomfördes utifrån kvalitativ metod. Studien bygger på nio intervjuer med personer diagnostiserade med bipolär sjukdom, som analyserades med hjälp av narrativ metod. I resultatet framkommer hur informanternas psykiska hälsa tog sig uttryck i hemmet, tillsammans med familjen och i skolan. Informanterna beskriver svårigheter att leva med bland annat djupa depressioner, förhöjd sinnesstämning, dåligt självförtroende och stress. Det meningsbärande är att alla upplevt psykisk ohälsa på olika sätt under skoltiden. Upplevelsen var att det fanns okunskap om psykisk ohälsa hos dem som arbetar i skolan. Gemensamt var att informanterna inte bad om hjälp och inte ville be om hjälp, men samtidigt önskade att någon skulle se, lyssna och fråga dem. Konklusionen är att skolan behöver uppmärksamma barns psykiska hälsa / Since it is known that mental illness is increasing, it is important to investigate how students with mental illness perceive their health in school and how they feel that school nurses could or should act. Bipolar disorder is a chronic, cyclical mood disorder, depression, hypomania and mania, which can be caused by both genetic factors as well as environmental factors. It is important that there is a high awareness of the condition among those who meet children with problems. School nurses are central to student health work and children's representatives, they must dare to look, listen and ask them about mental illness.The aim of the study was to describe how people with bipolar disorder experienced their mental health at school. The study was conducted using qualitative method. The study is based on interviews with nine people diagnosed with bipolar disorder, which was analyzed using the narrative method. The result shows how the informants' mental health was reflected in the home, along with the family and at school. The informants describe the difficulties of life, including severe depression, elevated mood, low self-esteem and stress. It is meaningful to all experienced mental illness in different ways at school. The perception was that there was ignorance about mental illness in those who work in the school. Common was that the informants are not asked for help and did not want to ask for help, but at the same time wished someone would look, listen and ask them. The conclusion is that the school needs to pay attention to children's mental health.

The aim of this study is to examine how young adults reason when it comes to mental illness among their peers and how they look upon seeking support and help for mental illness. This study is based on three focusgroupinterviews with 14 young adults in Sweden. The theoretical framework is labeling theory, which describes deviation as a process in which society forces social problems as a label onto people until they begin to identifies as deviants. Our results show that young adults are openminded when it comes to mental illness among their peers, but they are on the other hand negative towards seeking help for it. The explanation for this seems to be that many young adults have experiences of mental illness and therefor they believe it is a very important subject, although seeking help for it are strongly connected to stigma because of the prejudice that only people with severe psychological diagnoses are the ones that seek help. Most young adults with mental illness do not have psychological diagnoses and therefor associate seeking help with deviation. Other identified reasons for not wanting to seek help are lack of knowledge and bad experiences with former help-seeking.

This article is about the application of the two coercive legislations, Care of Abusers (Special Provisions) Act (LVM) and  the Compulsory Psychiatric Care Act (LPT) when individuals suffer from comorbidity. The authority who files the application for coercive interventions differs between the legislations. In LVM the social welfare board files the application and in LPT the chief psychiatrist.  Earlier research has shown that the individuals of the comorbidity group do not get their needs met in either of the legislations. It has also occurred that concrete arguments which relate to statutory criteria are missing. Our aim was to gain knowledge about how the court argued for these criteria, especially in cases where comorbidity exist. Another aim was to see which legislation that gave legal impact. Finally, we wanted to examine the roles of the chief psychiatrist and the social welfare board in court negotiations. We decided to study twenty court cases from Administrative court, ten cases from LVM and ten from LPT where the same individual had been committed to coercive care according to both legislations, this to capture the comorbidity. We interpreted the documents using discourse analysis and selected two concepts, inspired by Foucault and Fairclough, that we thought could be fruitful for our analysis. The result shows that there is more often argumentation about if the legal criteria in LVM are fulfilled compared to LPT where the argumentation is less informative. This result may have been influenced by the secrecy of Law. We also found out that the legislation that was given legal impact depended on the authorities assess of which need that was most urgent. The last finding was that the chief psychiatrist`s opinion was never questioned by the court, but the statements made by the social welfare board was.

Syftet med denna studie har varit att belysa män och kvinnors egna upplevelser av medberoende. I studien har en kvalitativ ansats använts och det material som har studerats är åtta förinspelade samtal, podcastavsnitt, publicerade på internet. Det empiriska materialet har analyserats utifrån teori om familjeroller och ett genusperspektiv. Denna studies resultat visade att de som ingår i studien påverkats negativt av en uppväxtmiljö präglad av missbruk eller psykisk ohälsa och upplevde sig ha anammat en eller flera roller för att kunna hantera sin livssituation. Resultatet visade även att detta fått konsekvenser för deltagarna i det vuxna livet. Vidare visade resultatet att män och kvinnor i denna studie i lika hög grad utvecklar ett medberoende, dock fanns det skillnader i hur studiens män och kvinnor uttrycker sitt medberoende. Kvinnorna upplevde att de isolerade sig, blev tystlåtna och tillbakadragna och männen upplevde att de hade ett mer utagerande beteende. Studiens deltagare hade upplevelser av att i barn- och ungdomsåren behöva ta ett stort ansvar och att de egna behoven därför åsidosattes. Slutligen diskuterades de negativa konsekvenserna av medberoende och om detta hade en koppling till rådande könsnormer. / The aim of this study was to illustrate male and females own experiences of codependency. In this study has an qualitative approach been used and the material consists of eight pre-recorded conversations, podcast episodes, published on the Internet. The empirical material has been analyzed from a theory of family roles and a gender perspective. It showed that the participants in this study has been negatively affected by growing up in an environment characterized of abuse or mental illness and felt that they had embraced one or more roles to manage their life situation. The result also showed that the participants had experienced negative consequences in adult life. The result of this study also showed that developing codependency was equally common among both male and female in this study, though were there differences between how male and females express their codependency. The females experienced a feeling of isolation, became quiet and reclusive and the males experienced that they had a more externalizing behavior. The experience of taking a big responsibility in childhood and adolescence was equally common among the participants of this study and led to that their own needs were ignored. The negative consequences of codependency and their connection to the gender norms of today were also discussed.

Bakgrund: Den psykiska ohälsan ökar i samhället och är i dag den vanligaste orsaken till sjukskrivning och längre sjukfrånvaro i Sverige. Vården av patienter med psykisk ohälsa är tidskrävande och behovet av resurser som denna patientgrupp kräver öppnar upp för nya arbetssätt för sjuksköterskan utöver dennes traditionella yrkesgräns. Syfte: Syftet med litteraturöversikten är att beskriva vilka sjuksköterskeledda omvårdnadsåtgärder som vidtas för patienter med psykisk ohälsa inom den öppna vården. Metod: En litteraturöversikt har genomförts, vilket i detta arbete innebär att åtta vetenskapliga artiklar har analyserats, fyra av dessa var av kvalitativ design, tre av kvantitativ design och en av mixad metod. Resultat: Litteraturöversikten resulterade i två huvudteman och fyra respektive två underteman. I huvudtemat genomförda omvårdnadsåtgärder beskrivs hur sjuksköterskan arbetar med bedömningssamtal, information, utbildning, guidning, kontinuerliga samtal samt psykoterapi. I andra huvudtemat effekter av genomförd omvårdnad beskrivs vilken inverkan sjuksköterskans omvårdnadsåtgärder kan få relaterat till sjuksköterskans engagemang samt på patientens symtom och behandling. Diskussion: De omvårdnadsåtgärder som beskrivs i resultatet diskuteras utifrån sjuksköterskan som en bidragande arbetskraft inom den öppna vården för patienter med psykisk ohälsa. Fynden diskuteras också utifrån omvårdnadsteoretikern Phil Barkers tidvattenmodell samt konsensusbegreppet människa. / Background: Mental illness is increasing in society and is today the leading cause off sick leave and extended sick leave in Sweden. The care of patients with mental illness are time consuming, and the need for resources that this group of patients requires are opening up for new ways for nurses to work, beyond their traditional profession. Aim: The aim of this literature review is to describe the nursing care for patients with mental illness in general outpatient care. Method: The method that was used in this paper is a literature review. Eight scientific articles were reviewed, four were of qualitative design, three of quantitative design and one of mixed method. Results: The literature review resulted in two main themes, divided in four and two sub themes. The main theme, performed nursing care, describes how the nurse is working with assessments, information, education, guidance, continuous talks and psychotherapy. The second main theme, the effects of the implemented nursing care, describes the impact of how nursing care measures may have affected the nurse’s commitment as well as on the patient’s symptoms and treatment. Discussion: The nursing care described in the results are discussed with the view of the nurse as a contributing labor in outpatient care for patients with mental illness. The findings are also discussed from the tidal model of nursing theorist Phil Barker, and the consensus concept of man.